In the four months after Gov. Andrew Cuomo announced his plan to legalize medical marijuana through an existing law, evidence of progress has been hard to come by.

Despite unprecedented support in both houses of the Legislature, including Senate Republicans who were previously opposed to the measure, legalization advocates are skeptical that a more comprehensive bill will pass this year.

And while the state’s health department announced earlier this year that at least ten hospitals statewide were interested in participating in the governor’s plan, representatives for several of the institutions in question, including Roswell Park Cancer Center, Montefiore Medical Center and New York City’s Health and Hospitals Corporation, told Capital they had not had any recent discussions with the state about how to move the program forward.

Cuomo’s plan, which would have legalized marijuana through an existing 1980 state law, was widely criticized as unworkable. It would allow just 20 hospitals statewide to dispense the drug and would require prospective patients to appear before a board of doctors to receive approval, which could create a bottleneck for thousands of patients seeking timely access to the drug.

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Critics of the program’s limited scale, including State Senator Diane Savino and Assembly health committee chairman Richard Gottfried, said the governor’s plan also relies on an unstable source for the drug’s supply, and could potentially use marijuana seized by law- enforcement officials, instead of the purified and specially-grown strains developed to treat specific medical conditions.

While medical marijuana stalls in New York, 21 other states have legalized it, including most of the liberal stronghold states along the Eastern seaboard—in recent years, New Jersey, Massachusetts, Rhode Island, Vermont, New Hampshire, Maine, Delaware and Connecticut have all legalized some form of medical marijuana.

While Democratic governors like Jerry Brown in California, Dannel Malloy in Connecticut, and Jay Inslee in Washington have said they are reluctant to legalize recreational marijuana use, each of those states has already made marijuana available for patients medicinally.

New York, which Governor Cuomo has touted as the birthplace of progressive politics, is the exception to the rule.

It may just be a matter of time, though. Support for legalizing medical marijuana has grown rapidly. In 2012, polls showed 57 percent of New Yorkers supported legalizing the drug for medical use. In recent months, polls have showed more than 80 percent of New Yorkers are in favor of it.

“I think he’s a little behind the curve,” Democratic political consultant Joe Mercurio said of the governor. Cuomo has expressed skepticism that a comprehensive bill to legalize the drug can pass the Legislature, but has yet to use his considerable political muscle to push for such a proposal.

By contrast, another governor with presidential aspirations, Maryland’s Martin O’Malley, signed a bill in early April to expand the state’s medical marijuana program, after a more limited program was deemed a failure.

Maryland’s experience with that smaller program may turn out to be instructive for New York. In late 2013, it began a limited medical marijuana program, which would have allowed patients to get the drug only at academic medical centers. But hospitals, at risk of losing federal grants if they dispensed a drug that is still illegal under federal law, wouldn’t sign on to the state’s plan.

Democrats see it as a potential strategy for boosting voter turnout, particularly among younger voters who are more likely to support legalizing the drug. Democrats in Florida are hoping a constitutional ballot initiative in the state’s 2014 elections will help secure the governorship for Charlie Crist, the embattled former Republican-turned-Democrat, as he seeks to recapture the office he lost in 2011.

Cuomo may just be biding his time. And for now, it’s still plausible for him to blame holdout legislators for the fact that New York isn’t doing more on this score.

But if a bill passes the Legislature and the governor fails to sign it?

It would be an “utter disaster,” Mercurio said. “If the Republican Senate voted for medical marijuana, and he voted against it, I can’t even begin to imagine what that would look like politically.”